1. Field of the Invention
This application relates to surgical instruments and, more particularly, to a surgical retractor which includes a grasping mechanism formed as a loop which may be wrapped around tissue or organs for manipulating the tissue or organ during an endoscopic surgical procedure.
2. Discussion of the Prior Art
In endoscopic and laparoscopic surgical procedures, it is often necessary to provide instrumentation to move or manipulate tissue and organs in the area of operation. Generally, laparoscopic surgical procedures involve the introduction of carbon dioxide to insufflate a body cavity, e.g., the abdomen, to provide a working area for the surgeon. After the abdomen is insufflated, a trocar device is utilized to puncture the peritoneum to provide an access port through the abdominal wall for the introduction of surgical instrumentation. Generally, a trocar cannula is placed through the abdominal wall for each piece of surgical instrumentation which is necessary to carry out the surgical procedure. In this manner, the surgeon may view the surgical site through an endoscope provided through a first trocar cannula, and utilize a second trocar cannula to introduce a surgical instrument such as a grasper, scissors, clip appliers, stapler, and any other surgical instrument which may be necessary during that particular surgical procedure.
Although the insufflation gas expands the abdomen to permit the surgeon to view the surgical site, it is often necessary to manipulate the internal organs or tissues to provide a clear path to the surgical objective. In the prior art, it has been known to utilize grasping tools which pull on the organs or tissues to move them out of the way to provide a clear visual path for the surgeon. However, these devices may damage the organs or tissues which they grasp, and consequently these devices are utilized only when absolutely necessary. In order to avoid the problems associated with grasping tools, endoscopic retractor mechanisms have been developed which are utilized to push and hold the tissue or organs away from the surgical site. Typically, these devices include paddles and/or fingers which expand after the retractor has been inserted into the abdomen through the trocar cannula. Such devices are disclosed in, for example, U.S. Pat. No. 4,654,028 to Suma, U.S. Pat. No. 4,909,789 to Taguchi et al., and U.S. Pat. No. 5,195,505 to Josefsen. Other retractor devices include collapsible fingers joined by webs of resilient material which expand to form the retractor. These devices are disclosed in, for example, U.S. Pat. No. 4,190,042 to Sinnreich and U.S. Pat. No. 4,744,363 to Hasson. Other devices include retractors having expandable frames for supporting expandable latex sheaths or covers, such as that described in U.S. Pat. No. 5,178,133 to Pena.
While one or more of the aforementioned devices has been successfully used in laparoscopic procedures, larger organs, such as the intestine and/or stomach, tend to be too large and too heavy to be properly supported by these retractors. Consequently, the retractors have difficulty in clearing the surgical field to provide access for the surgeon to the surgical site. Due to the small size of the instrumentation, particularly the trocar cannula through which these instruments must pass, it is difficult to provide a retractor mechanism which can support or otherwise manipulate large and pliable organs such as the intestines or stomach.
Therefore, a need exists for a retractor mechanism which may be utilized to manipulate large organs without damaging the tissue of these organs, and which is reliable as far as the strength and durability of the instrument is concerned. A need also exists for a retractor instrument which may clear the surgical site of heavy organs and tissue, where the instrument is small in relation to the organ and may be utilized with conventional trocar cannulas to provide access to the site during an endoscopic or laparoscopic surgical procedure.
The device disclosed herein overcomes the disadvantages associated with the prior art and provides a lightweight retractor device which allows the surgeon to manipulate large organs and other pliable tissue.